Vincristine Sulphate

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Vincristine, a widely used chemotherapeutic agent, should only be administered intravenously, and never by any other route. Many patients receiving intravenous vincristine also receive other medication via a spinal route as part of their treatment protocol. This has led to errors where vincristine has been administered via a spinal route.

Following a death due to intrathecal vincristine in July 2007, WHO issued the following alert:

WHO Recommendations

The WHO World Alliance for Patient Safety has consulted expert opinion widely and recommends the following actions be taken:

The labelling of vincristine should include a clear warning label that reads: ‘FOR INTRAVENOUS USE ONLY - FATAL IF GIVEN BY OTHER ROUTES’.

Syringes should not be used for vincristine administration.

Vincristine should where possible be prepared by dilution in small volume intravenous bags (the ‘minibag’ technique), rather than in a syringe, to protect against accidental administration via a spinal route.